Anemia is common in patients with systemic rheumatic disease, yet it may not get the attention it deserves. Anemia can result from chronic inflammation, treatment side effects or other disease factors, or it may signal an unrelated condition. Although diagnosis and treatment of anemia are sometimes challenging, clinicians must do their utmost to rigorously investigate the cause of anemia and treat where appropriate. With new drugs on the horizon to treat the anemia of inflammation, clinicians may soon have new treatment options to manage this condition.1
Many patients with systemic rheumatic disease have anemia of inflammation (sometimes called anemia of chronic disease) as a secondary result of their condition. However, many other kinds of anemia occur in rheumatic patients. If clinicians simply assume anemia is due to disease inflammation, they can miss other important medical conditions, such as chronic gastrointestinal bleeding and malignancy.1
Anemia of inflammation seems to correlate with disease severity and disease activity. In studies of quality of life in patients with rheumatoid arthritis, resolution of anemia often correlates with resolution of symptoms and improved quality of life.2 Hemoglobin levels also correlate with the risk of certain comorbidities like cardiovascular disease.3 Yet it is something of an open question as to how much low-level anemia directly affects patients’ quality of life, disease morbidity and mortality. It may serve more as an indicator of overall disease status.